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January 1965

Nontraumatic Perforation of Common Hepatic Duct

Author Affiliations

From the Surgical Service, St. Luke's Hospital.

Arch Surg. 1965;90(1):118-122. doi:10.1001/archsurg.1965.01320070120026

IN 1882, JOHN FREELAND5 described the first case of nontraumatic perforation of the common hepatic duct. Since then, only eight cases have been reported. When confronted with two cases within a six-month period at St. Luke's Hospital, we felt that a report of these two cases and a brief review of the previously reported cases would be of special interest.

Report of Cases  (No. 44-64-30): A 56-year-old male was admitted to St. Luke's Hospital with abdominal pain of ten hours' duration. In 1939 the patient had a plication of a perforated duodenal ulcer, followed by a subtotal gastric resection in 1952. He was apparently well until the morning of admission when he was awakened with severe midabdominal pain associated with vomiting of bile-stained material. There were no other gastrointestinal symptoms. The past history was significant in that pulmonary tuberculosis was suspected in 1952.The patient was a well-developed, thin